AB0694 VITAMIN D LEVELS IN SERUM OF PATIENTS WITH SYSTEMIC SCLEROSIS AND VERY-EARLY SYSTEMIC SCLEROSIS (VEDOSS)
Authors: G. Cuomo, M. C. Trotta, C. Di Vico, R. Ferrara, C. Romano, M. D’Amico
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic sclerosis (SSc) is a chronic disease characterized by autoimmunity, vasculopathy, and visceral and cutaneous fibrosis and very-early systemic sclerosis VEDOSS is characterized by Raynaud’s phenomenon with SSc marker autoantibodies and typical capillaroscopic finding. Vitamin D has several functions in the immunological system, and different studies have suggested a potential role in triggering autoimmune diseases. (1,2) Objectives Our goal was to verify the difference of Vitamin D levels causal in SSC definite and VEDOSS population, and relationship between hypovitaminosis D and SSc characteristics Methods 42 adults with SSc were recruited: 24 with American College of Rheumatology criteria were affected by diffuse systemic sclerosis (4) and limited systemic sclerosis (20); 18 with VEDOSS criteria. Patients were evaluated from medical history and physical examination (modified Rodnan skin score and the presence / number of ulcers), biohumoral evaluation of routine, electrocardiogram, echocardiogram, pulmonary function tests, high resolution computed tomography of the chest, capillaroscopy. For the determination of total vitamin D levels (25-OH), the serum samples were suitably centrifuged at 4 ° C at 3500g. Vitamin D levels were then determined by a two-step chemiluminescence enzyme immunoassay (CLIA), with a maximum limit of 100 ng / ml. Results The 42 subjects recruited (4 men and 38 women); age 48.2 ± 11.5 years (mean ± SD). All subjects were ANA positive, with anti-Scl70 positivity in dcSSc patients (4) and anti-centromere lcSSc patients (18). Patients with VEDOSS showed optimal serum levels of vitamin D (33.93 ± 3.5 ng / ml). Conversely, patients with systemic sclerosis showed serum levels of vitamin D at the limit of sufficiency (21.75 ± 4.0 ng / ml). (Figure 1) In particular, in the group of patients with systemic sclerosis, vitamin D levels were significantly reduced by 1.5 times (P &lt;0.05) compared to VEDOSS group. In patients with SSc the serum levels of vitamin D were inversely proportional to the presence of mega capillaries. Furthermore, a directly proportional correlation of the serum levels of vitamin D with the age of the patient. It is therefore possible to assume that higher levels of vitamin D delay the onset of the disease, while lower levels of vitamin D favor the onset of the same. Conclusion Considering our findings from this work, it is possible to consider the Vitamin D supplement in patients suffering from sclerosis, especially as an adjuvant in the initial phase of the disease, thus hypothesizing a slowdown in the progression of the disease and an improvement in prognosis. References [1]S. Bellando-Randone, F.Del Galdo, G. Lepri, t al. Progression of patients with Raynaud’s phenomenon to systemic sclerosis: a five-year analysis of the European Scleroderma Trial and Research group multicentre, longitudinal registry study for Very Early Diagnosis of Systemic Sclerosis (VEDOSS). Lancet Rheumatol 2021; 3: e834–43 [2]Rosen Y, Daich J, Soliman I, Brathwaite E, Shoenfeld Y. Vitamin D and autoimmunity. .Scand J Rheumatol. 2016 Nov;45(6):439-447. Figure 1. Disclosure of Interests None declared